The quality of evidence is downgraded by indirectness (differences between the outcomes of interest and those reported: evidence for the longer-term effects of these programmes is unavailable).
A Cochrane review included 13 studies (10 RCTs and 3 quasi-randomised trials) with a total of 1 078 subjects. Cognitive-behavioural group-based parenting interventions for parents of children aged 3 to 12 years with conduct problems were compared with a waiting-list control group. Parent training produced a statistically significant reduction in child conduct problems, whether assessed by parents (SMD -0.53, 95% CI -0.72 to -0.34) or independently assessed (SMD -0.44, 95% CI -0.77 to -0.11; statistical heterogeneity I2=64%). The intervention led to statistically significant improvements in parental mental health (SMD -0.36, 95% CI -0.52 to -0.20) and positive parenting skills, based on both parent reports (SMD -0.53, 95% CI -0.90 to -0.16; I² = 70%) and independent reports (SMD -0.47, 95% CI -0.65 to -0.29). Parent training also produced a statistically significant reduction in negative or harsh parenting practices according to both parent reports (SMD -0.77, 95% CI -0.96 to -0.59) and independent assessments (SMD -0.42, 95% CI -0.67 to -0.16). Moreover, the intervention demonstrated evidence of cost-effectiveness. When compared to a waiting list control group, there was a cost of approximately $2500 (GBP 1712; EUR 2217) per family to bring the average child with clinical levels of conduct problems into the non-clinical range. These costs of programme delivery are modest when compared with the long-term health, social, educational and legal costs associated with childhood conduct problems.
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